Emergency medicine journal : EMJ
-
Previous research has shown the safety of procedural sedation in the emergency department in university settings involving multiple emergency physicians. ⋯ Procedural sedation in the emergency department performed by a single emergency physician is safe and effective.
-
To examine the outcomes of calls to NHS Direct (NHS-D) in relation to attendance at the accident and emergency (A&E) department. ⋯ Delivering telephone advice about illness severity in children is difficult as visual clues are so important. More collaborative prospective studies are needed, including with primary care, to understand families' choices, and to refine and assess NHS-D's ability to discriminate those requiring further clinical assessment.
-
Patients with orbital cellulitis present to emergency departments occasionally. Symptoms usually develop rapidly, with patients being distressed by painful ocular movements and systemic upset. The case of a 24-year-old man who had a 1-month gradual history of intermittent periorbital swelling after a flu-like illness, and subsequently developed a large intracranial extradural abscess eroding through the temporal bone, ultimately requiring neurosurgical intervention is presented. ⋯ Accurate diagnosis is therefore of great importance. In this case, the patient presented with few clinical signs but relevant pathology. The importance of assessing ocular movement, which is a major clinical abnormality indicating orbital disorder and thus an aid to accurate diagnosis, should be highlighted.
-
The chest cage is a common target for traumatic damage. Although relatively rare, it is considered to be a serious condition with significant reported mortalities. As most flail injuries are accompanied by severe extrathoracic injuries, it is often difficult to pinpoint a single injury responsible for the patient's death. ⋯ Advanced age is associated with higher mortality. Isolated unilateral bony cage instability infrequently leads to death in patients who make it to the emergency department but rather its combination with additional extrathoracic trauma.
-
Following the accession of Poland to the European Union in 2004, large numbers of Polish migrant workers have come to the UK. We describe how this migration has impacted on an emergency department in the West Midlands, and suggest advice that should be given to such visitors about how to use the NHS.